Question Title: Scoliosis, Spasmodic Torticollis and Cervical Rib

In 1991, I had two rods placed in my back for scoliosis. Previous to that I was having severe neck problems that the surgeon expected to go away after the operation. There is no history in my family of scoliosis. The pain continued and I was sent to a neurologist who decided the problem was a cervical rib which he removed in 1995. I developed a staph infection and was put on bactrim from which I had a severe reaction. The pain in my neck was not corrected and he then sent me to have an emg performed by another doctor and it was decided at that point I had Spasmodic Torticollis. I went to another neurologist at another hospital after researching specialists in this movement disorder. After the cervical rib operation I started feeling sensations in my arms like pins and needles and when I held the phone too long or a bag, I could see discoloration in my fingers. It is now to the point I am in severe pain with it spreading up my arms, my right side is worse. There is also a numbness and if at night I place my right arm above my head, the pain in lowering it can be excrutiating. I have experienced dryness in mouth, constipation and now have an ache in my chest which I would liken to a sprained rib, hurts when I take a deep breath. I am constantly out of breath and feel it more walking stairs. I feel my body is racked with pain and I'm concerned as it is getting worse. I'm scheduled for another emg but do you think the removal of the rib upset the rods in my back and caused this pain which is escalating. I also have difficulty opening jars etc and tying my shoes. Please help.

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Your case is very complex.

Spasmodic torticollis is a form of cervical dystonia. Dystonia, in general, is a disorder of posture control in the brain. The deep brain structures which control posture (without your having to be aware of it) somehow get the wrong "set point" for posture of the affected part of the body. Dystonia can affect the head/neck, arms, back, legs, even the voice.

There are many causes for scoliosis. Dystonia is one of them. One wonders if you've had dystonia unrecognized for a long time which curved your back and twisted your neck.

Dystonia is often painful.

I can't comment on the effects of the rib removal with any authority. I wonder about possible reflex sympathetic dystrophy (RSD) but my expertise is really limited there. Ask your doctor or see a pain specialist for an opinion whether that is what is happening to you. There is a syndrome called dystonia-causalgia which is related to RSD, but again I can't make that diagnosis in this format.

You've really got a complicated situation. I hope your doctors are able to figure out what is going on. If not, you are welcome to call 800 223-2273 and ask for neurology appointments. A movement disorders specialist here may be able to define your syndrome of dystonia (that is, tell you whether it is limited to cervical dystonia or is more extensive, and how much contribution it might have to your other problems or if there is more than one cause for all of them). You also may get advice regarding whether it is appropriate to use BoTox (botulinum toxin) for treatment of your dystonia. As you know, this forum is only for educational purposes and can't be used for actual medical advice.

I hope this helps. CCF MD mdf.

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